Revenue Cycle Process and Quality Specialist

Hackensack Meridian Health•Tinton Falls, NJ

15d•Hybrid

About The Position

Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. The Revenue Cycle Process and Quality Specialist plays a vital role in optimizing team member efficiency and effectiveness in support of revenue maximization for HMH. Providing critical assistance to the Claims, Accounts Receivable, and Patient Financial Experience departments with a focus on revenue cycle processes, including but not limited to documentation, training, and quality assurance. This is a Hybrid position for Patient Financial Services! This requires to be onsite for meetings and training as needed - generally 2-4 times per month. Location can be either Hackensack, Edison, or Tinton Falls Schedule is Monday-Friday days 8am - 4:30pm or 8:30 am. - 5pm

Requirements

College credits or industry certifications such as those from the Healthcare Financial Management Association (HFMA) or LinkedIn Learning paths, related to revenue cycle management, and a high school diploma.
A minimum 5 years of experience in a hospital revenue cycle role, with a strong understanding of claims, billing, accounts receivable, and patient financial services.
Experience with Epic Hospital Billing (HB).
Demonstrated knowledge of hospital billing regulations, payer requirements, and industry best practices.
Excellent written and verbal communication skills, with the ability to present complex information clearly and concisely.
Keen attention to detail and the ability to organize documentation in an online environment.
A collaborative team player with the ability to build and maintain effective working relationships across multiple departments.
The ability to evaluate and assess work for accuracy, quality and adherence to established procedures.
Outstanding work ethic and reliability.
Excellent written and verbal communication skills.
Proficient computer skills that include but are not limited to Google Suite and/or Microsoft Office platforms.

Nice To Haves

Proven experience in process documentation, curriculum development, or training is highly desirable.
Bachelor's degree in Healthcare Administration, Business, or a related field.
In depth knowledge of the revenue cycle. (third party follow up, reconciliation, billing and other key areas of patient financial services)
Dedication to continuous learning and expansion of relevant job knowledge.
Experience in analysis of accounts in a hospital or physician environment.
Knowledge of medical terminology, hospital systems, and insurance processes.
Knowledge of Google Docs/Sheets/Slides.

Responsibilities

Documenting operational processes by developing and maintaining comprehensive, department-specific procedures for all areas of patient financial services, including claims submission, accounts receivable management, and patient financial interactions.
Cataloging of procedures and departmental guides; creating and managing a centralized catalog of all revenue cycle procedures, ensuring materials are up-to-date, consistent, and easily accessible for reference by all team members.
Act as a key liaison to the Revenue Cycle Training team, assisting in the identification of detailed operational training needs and the development of educational materials in support of new workflow.
Perform regular quality reviews and audits as directed by leadership; ensuring adherence to established procedures, to identify trends, and recommend process improvements. Shares audit findings with training for improvement opportunities
Assisting leadership with the training and onboarding of new hires, providing them with the foundational knowledge and resources to succeed.
Audits training material and courses put forward by Revenue Cycle Training team to provide feedback, guidance and areas for improvement to ensure effective delivery of course material and content.
Preparing and updating clear and concise guide sheets and job aids for facility and program-specific revenue cycle functions.
Together with leadership, identify key process areas and control points to build a robust quality assurance framework.
Recommends process improvements based on workflow assessment and best practice information.
Works closely with Leadership to ensure departmental functions are documented properly and are being followed.
Participates in Compliance and Internal Audit reviews as requested by Leadership; provides requested information and assists with development of action plans.
Coordinates efforts between departments to ensure workflow is captured correctly.
Provides training as directed by Leadership for new hires or new initiatives.
Schedules and leads meetings with appropriate personnel to exchange information and document workflow.
In collaboration with Leaders and Trainers, develop educational materials stemming from improvement initiatives, new regulations, or quality improvement.
Performs other job-related duties as required or assigned including but not limited to assisting in training team members.
Other duties and/or projects as assigned.
Adheres to HMH Organizational competencies and standards of behavior.